Nasal Pillows not intuitive for sizing headgear

The Swift nasal pillows seem to be somewhat nonintuitive.

I'm not even sure the folks who write the Resmed instructions understand it. I've read a lot of stuff, but only in two places (one being this forum) did I read that the way to fit the mask and headgear is lying down with airflow.

And if you look at how the NP is designed, that makes sense, because the design treats the outer cones of the nosepiece as if they were little baloons, and by that I mean that when there is airflow the pressure naturally pushes them up and outward, almost inflating them, which presses them against your nostrils creating a nice soft seal.

So if you try to size the headgear without the airflow, the cones are a bit limp and noncompliant, so the natural tendency is to tighten the headgear to get them to feel like they will stay in place. But that is actually too tight once you have airflow, and without someone explaining that, it becomes the textbook definition of "nonintuitive".

I made this rookie mistake myself, which resulted in the inner part of the nosepiece digging into my nostril constantly. Not a pleasant way to sleep.

I wish my DME, also a CPAP and NP user, would have explained that to me, which would have saved me a lot of grief over the past week. He was good, and spent 20 minutes with me, but never imparted this basic gem, which seems like about the first thing us virgins need to know. I rassled with it for about a week trying to get to where I understood this, and I am an Engineer by trade, so I feel a bit foolish for not understanding it a little earlier. I also did not get the warning "don't make it too tight"; all I got was "do what feels comfortable". I didn't even discover that there were various NP sizes included until I was about to do a mask swap out of frustration.

Even the waiter in a Mexican restaurant warns everyone the basic information that "these plates are hot", so I am puzzled by how a trained, experienced DME can not cover the basics properly. I even had the mask upside down the first two nights, because that was not demonstrated either.

If I had not discovered this wonderful resource (this forum) I might still be trying to figure this out.

tyroneshoes2 wrote:Even the waiter in a Mexican restaurant warns everyone the basic information that "these plates are hot", so I am puzzled by how a trained, experienced DME can not cover the basics properly. I

easy, waiters want a tip.

Fortunately, there are videos on YouTube that will demo how to do nearly anything cpap-related.
Often cpap.com will provide their own videos or links to other videos on their product pages.
Forum members know of even more sources of information. Welcome to Cpap University.
Study hard; pop quizzes can be any night.
Don't be surprised to eventually have more knowledge than the professionals who claim to know it all.